Renata Carvalho Da Fonseca DDS., a Dental Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

RENATA CARVALHO DA FONSECA DDS., A DENTAL CORPORATION

Practice address

23101 Sherman PL Ste 201
West Hills, CA 91307-2019

Phone

(818) 716-8424

NPI assigned

Nov 12, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Renata Carvalho Da Fonseca, DDS

Title

President

Phone

(310) 463-3294

Specialties & licenses 4

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1588209712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 WASHINGTON BLVD UNIT 523",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925421",
            "telephone_number": "310-463-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23101 SHERMAN PL STE 201",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913072019",
            "telephone_number": "818-716-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENATA CARVALHO DA FONSECA DDS., A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "DA FONSECA",
        "authorized_official_first_name": "RENATA",
        "authorized_official_middle_name": "CARVALHO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-463-3294",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in West Hills, CA
• Providers in West Hills, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.